. The principles and practice of modern surgery . important connexions with thesac. If the tumour, to use Mr. Prescott Hewetts words, correspondsto the two or three upper lumbar vertebrae only, the cord itself rarely de-viates from its course, and the posterior spinal nerves are generally theonly branches which have any connexion with the sac. But if the tumouroccupies partly the lumbar and partly the sacral region, then generally thecord itself and its nerves will be found intimately connected with the Cruveilhier believes from his dissections that this connection isconstant. This is
. The principles and practice of modern surgery . important connexions with thesac. If the tumour, to use Mr. Prescott Hewetts words, correspondsto the two or three upper lumbar vertebrae only, the cord itself rarely de-viates from its course, and the posterior spinal nerves are generally theonly branches which have any connexion with the sac. But if the tumouroccupies partly the lumbar and partly the sacral region, then generally thecord itself and its nerves will be found intimately connected with the Cruveilhier believes from his dissections that this connection isconstant. This is well illustrated by the accompanying sketch (fig. 95) of a pre-paration in the St. Georges Hospital Museum, made by Mr. Hewett, whokindly obtained permission for the author to have tlie drawing made. The Fit;. 95. 96.«. patient was fivf months old, and died under Mr. Tatums care. Thecavity of the tunioiir is .veen to be intcrsecled by the cord, and by thenerves emanating from it. The cord and its nerves ^passing out of thespinal canal at the uj)i)er part of the opening run across the cavity of the • KfiirosciiU the tumour fennL-d in ^llil.;l From tLc Kings Collrgo colleciion. SPINA BIFIDA. 331 tumour to its posterior wall, where they are firmly fixed, the nerves beinghere flattened and spread out upon a fine membrane. From the sac, theanterior branches of the first four sacral nerves return in distinct bundles,forming large loops, to the anterior sacral foramina, through which theypass as usual to form the sacral plexuses. The fluid had evidently beeneffused between the visceral arachnoid and pia mater; and the walls ofthe sac were formed by the visceral and parietal arachnoid and by the skin,all of which were much thickened, and firmly united to each other. In cases like this, in which t
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Keywords: ., bookcentury1800, booksubjectgeneralsurgery, booksubjectsurgery
